CKD in China: Evolving Spectrum and Public Health Implications

医学 糖尿病 透析 公共卫生 心理干预 糖尿病肾病 肾病 肾脏疾病 中国 重症监护医学 环境卫生 内科学 内分泌学 病理 护理部 法学 政治学
作者
Chao Yang,Haibo Wang,Xinju Zhao,Kunihiro Matsushita,Josef Coresh,Luxia Zhang,Ming‐Hui Zhao
出处
期刊:American Journal of Kidney Diseases [Elsevier]
卷期号:76 (2): 258-264 被引量:153
标识
DOI:10.1053/j.ajkd.2019.05.032
摘要

Diabetes is the leading cause of kidney failure worldwide, whereas glomerulonephritis has been predominant in developing countries such as China. The prevalence of obesity and diabetes has increased dramatically in developing countries, substantially affecting the patterns of chronic kidney disease (CKD) observed in these regions. Using data from the Hospital Quality Monitoring System to evaluate changes in the spectrum of non-dialysis-dependent CKD in China, we have observed an increase in the percentage of patients with CKD due to diabetes, which has exceeded that of CKD due to glomerulonephritis since 2011, as well as an increase in hypertensive nephropathy and, in some regions, obstructive kidney disease (mostly associated with kidney stones). The growth of noncommunicable diseases under profound societal and environmental changes has shifted the spectrum of CKD in China toward patterns similar to those of developed countries, which will have enormous impacts on the Chinese health care system. There is much to be done regarding public health interventions, including the establishment of a national CKD surveillance system, improvement in the management of diabetes and hypertension, and enhancement of the affordability and accessibility of kidney replacement therapy. Reducing the burden of CKD will require joint efforts from government, the medical community (including practitioners other than nephrologists), and the public.
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